Before Birth. Prenatal Testing for Genetic Disease

"science of woman," the doctrine of the nature and diseases of woman as distinct from man, became embodied in gynecology. Moreover, this new specialty of physicians constructed a theory of femininity which prescribed social roles without raising opposition, because they had the validation of science. Women became identified as a special group of patients, based upon their reproductive capacities. As woman was dominated by her sexual functions, the physiology and pathology of her reproductive system provided the key to understanding her physical, mental, and moral peculiarities. Thus, ideologically charged beliefs about the biological foundations of femininity provided the organizing concept around which gynecology grew as a theory of femininity and a therapeutic art. Consequently, according to Moscucci, obstetrics and gynecology justified its existence by the utility its theories had in maintaining the social order. In her book, Moscucci explores the medical and social context in which the "science of woman" was allowed to take root and flourish. Despite the usefulness of much of the book's factual content, Moscucci's work disappoints on two accounts. First, she places an inordinate emphasis on her revisionist agenda. Portrayed as a mere social climber, the medical man yearns not for new remedies but for status and wealth, his doubtful abilities bolstered by family and school ties. Such a history neglects and denigrates the achievements of such notables as James Young Simpson, Carl Crede, and John Braxton Hicks. Second, Moscucci presents the argument that professional identity was achieved not through advances in medical practice but by the espousal of an ideology generated to subjugate women to traditional roles. Although eloquently argued, the theory seems shrill and hollow, and inadequately explains both the development of the "scientist-physician" cult by the 1920s and the enduring success of the specialty. Still, the work is scholarly and well written, providing a social history of the evolution of a medical specialty usually neglected by historians. As such, it is a welcomed addition.